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Updated: Nov 6, 2025
Using a Split-belt Treadmill to Evaluate Generalization of Human Locomotor Adaptation
Published on: August 23, 2017
The Effect of Split-Belt Treadmill Interventions on Step Length Asymmetry in Individuals Poststroke: A Systematic
Alex C Dzewaltowski1, Erica A Hedrick1, Todd J Leutzinger1
1University of Nebraska at Omaha, Omaha, NE, USA.
Background:
Individuals poststroke experience gait asymmetries that result in decreased community ambulation and a lower quality of life. A variety of studies have utilized split-belt treadmill training to investigate its effect on gait asymmetry, but many employ various methodologies that report differing results.
Objective:
The purpose of this meta-analysis was to determine the effects of split-belt treadmill walking on step length symmetry in individuals poststroke both during and following training.
Methods:
A comprehensive search of PubMed/MEDLINE, CINAHL, Web of Science, and Scopus was conducted to find peer-reviewed journal articles that included individuals poststroke that participated in a split-belt treadmill walking intervention. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) was used to assess risk of bias. Pooled Hedge's g with random effects models were used to estimate the effect of split-belt training on step length symmetry.
Results:
Twenty-one studies were assessed and included in the systematic review with 11 of them included in the meta-analysis. Included studies had an average STROBE score of 16.2 ± 2.5. The pooled effects for step length asymmetry from baseline to late adaptation were not significant (g = 0.060, P = .701). Large, significant effects were found at posttraining after a single session (g = 1.04, P < .01), posttraining after multiple sessions (g = -0.70, P = .01), and follow-up (g = -0.718, P = .023).
Conclusion:
Results indicate split-belt treadmill training with the shorter step length on the fast belt has the potential to improve step length symmetry in individuals poststroke when long-term training is implemented, but randomized controlled trials are needed to confirm the efficacy of split-belt treadmill training.
